Diagnostic Evaluation: Disruptive Behavior Disorders

What are Disruptive Behavior Disorders (DBD)?

Children with disruptive behavior disorders have ongoing patterns of uncooperative and defiant behavior that impacts those around them including their family, friends, peers, and teachers.

Signs of Disruptive Behavior Disorders

It is common for children with disruptive behavior disorders to be stubborn, difficult, disobedient, and irritable. These children may have a tendency to be physically aggressive, intentionally violate others’ rights, and have a hostile or indifferent response to authority figures. 

Types of Disruptive Behavior Disorders

The three main types of disruptive behavior disorders are Conduct Disorder (CD), Oppositional Defiant Disorder (ODD), and Disruptive Behavior Disorder Not Otherwise Specified (DBD NOS). The difference between these disorders are severity, intensity, and intentionality of the behavior exhibited.

Note: Children may be diagnosed with Disruptive Behavior Disorder Not Otherwise Specified (DBD NOS) early in the diagnosis process if their behavior cannot be categorized as Conduct Disorder (CD) or Oppositional Defiant Disorder (ODD). This diagnosis requires further investigation and testing to gather enough data to specify the type of disruptive behavior disorder.

Causes of Disruptive Behavior Disorders


It is common for children with disruptive behavior disorders to have parents with mental health disorders. These disorders may include substance abuse, attention-deficit disorder, attention-deficit hyperactivity disorder, mood disorder, schizophrenia, or antisocial personality disorder. 


Children who have experienced a negative environment are at risk for developing disruptive behavior disorders. This may include:

  • Rejected by their mothers as infants
  • Separated from their parents
  • Recipients of poor foster care
  • Physically, emotionally, or sexually abused
  • Neglected
  • Lived in poverty
  • Witnessed domestic violence 
  • Witnessed substance abuse


Children who were born at a low birth weight or suffered neurological damage at any point in their childhood are at a greater risk for developing disruptive behavior disorders.


Children with psychological conditions are at a higher risk for developing disruptive behavior disorders. A high rate of children with attention-deficit hyperactivity disorder develop disruptive behavior disorders in their childhood 

Diagnosis of Disruptive Behavior Disorders

Challenges of diagnosis

Disruptive behavior disorders are difficult to diagnose due to the presence of comorbidities and behavior changes. Children living with anxiety, depression, chronic stress, chronic illness, or other debilitating conditions may act out in ways that are perceived to be disruptive behavior disorders. Children with disruptive behavior disorders experience dysfunctional relationships in all areas of their life which contributes to the challenge of providing an accurate diagnosis.

Who diagnoses a child with Disruptive Behavior Disorders?

A child is diagnosed with disruptive behavior disorders by an expert trained in the field of childhood development and behavior. These experts include psychologists, psychiatrists, and developmental-behavioral pediatricians.

What is the diagnostic process?

Diagnosing a child with disruptive behavior disorders requires a comprehensive psychiatric assessment. This assessment includes input form both the child and parents/caregivers. 

What is a comprehensive psychiatric assessment?

A comprehensive psychiatric assessment includes gathering data, interviews, and questionnaires.

What data is gathered?

An important part of the comprehensive psychiatric assessment is gathering data about the  child’s family history, medical history, school life, social interactions, and symptoms to create a profile.

Who is being interviewed?

Interviews include the child, parents/caregivers, teachers, family members, or any other people who play an important role in the child’s life. The interviews help to create a better picture of the child and provide insight on the child’s behaviors and choices from different perspectives.

What are questionnaires used for?

Questionnaires are useful for providing the diagnostic team with insight on the effects of a child’s behaviors in different areas of their life. The child, parents/caregivers, teachers, family members, or any other important person in the child’s life are invited to complete questionnaires so the diagnostic team can create a comprehensive profile of the child. Questionnaires allow the diagnostic team and the child’s loved ones to create treatment goals that work best in each area of life.

Treatment of Disruptive Behavior Disorders

Treatment of disruptive behavior disorders is unique to each child. The age of the child highly affects the treatment approach. Children under the age of nine benefit from treatment that relies heavily on parents and other adults managing the child’s behaviors in different settings. This requires parents/caregivers, teachers, and other adults in the child’s life to be trained on the specific approach to the child in order to increase the effectiveness of treatment.

Children over the age of nine are responsible for more self-awareness throughout their treatment. They are taught special behavioral techniques and coping strategies but are required to adopt them at home, school, and in public to manage their behaviors.